Abnormal Uterine Bleeding by Danielle Austin, MD FACOG
Help! Is my menses normal?
Menses vary from woman to woman, but in general they occur every 24 to 38 days and last up to 8 days. When a menses is not normal, it is called Abnormal Uterine Bleeding (AUB).
Examples of abnormal menses include:
- Cycle occurs more often than every 24 days or longer than every 38 days
- Variation between cycle length is more than 7-9 days
- Menses lasts for longer than 8 days
- Bleeding or spotting occurs between menses
- Bleeding occurs with sex
- Heavy menstrual flow
- Bleeding after menopause
There are two times in a woman’s life when it is normal to have irregular bleeding. These are when a woman first starts having her menses or is transitioning into perimenopause. The cycle length can vary and women can even skip menses. Bleeding can also become heavy or light.
What causes abnormal uterine bleeding?
There are many causes of abnormal bleeding. Below is a list of some of the causes:
- Pregnancy, such as miscarriage and ectopic
- Fibroids and polyps
- Issues with ovulation
- Infection, such as sexually transmitted or an infection of the uterine cavity
- Thyroid disease
- Certain medications
- Birth control methods, including birth control pills and IUDs
What tests will be done?
Many tests can determine the cause of abnormal uterine bleeding. The type of tests done also depend on your age and medical history. In general, the types of tests done include:
- Pregnancy test
- Cultures – check for a sexually transmitted infection
- Bloodwork – assess if your thyroid is working properly. May also screen for other conditions, such as polycystic ovarian syndrome and perimenopause depending on your cycle and bleeding
- Ultrasound – determine if polyps or fibroids are the cause of your bleeding
- Endometrial biopsy – assess for an infection of the uterine cavity and uterine cancer
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Additional information can be found at ACOG FAQ’s
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